Provider Demographics
NPI:1518954312
Name:SURGICAL ASSOCIATES CHARTERED
Entity Type:Organization
Organization Name:SURGICAL ASSOCIATES CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RODEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHBAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-427-1630
Mailing Address - Street 1:5801 ALLENTOWN RD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMP SPRINGS
Mailing Address - State:MD
Mailing Address - Zip Code:20746-4563
Mailing Address - Country:US
Mailing Address - Phone:240-427-1630
Mailing Address - Fax:240-492-2070
Practice Address - Street 1:5801 ALLENTOWN RD
Practice Address - Street 2:SUITE 502
Practice Address - City:CAMP SPRINGS
Practice Address - State:MD
Practice Address - Zip Code:20746-4563
Practice Address - Country:US
Practice Address - Phone:240-427-1630
Practice Address - Fax:240-492-2070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2085R0204X, 208600000X, 2086S0129X, 208G00000X
MD332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD=========OtherTAX ID
MDP91420Medicare UPIN
MDS84053Medicare UPIN
429555Medicare PIN
MDH43765Medicare UPIN
MD6943350001Medicare NSC
MDKN56Medicare PIN
MDI36079Medicare UPIN
MDB66909Medicare UPIN
MDB94310Medicare UPIN
MDH04537Medicare UPIN
MDE93554Medicare UPIN
MDC62118Medicare UPIN
MDG80813Medicare UPIN
B94699Medicare UPIN
MDG98307Medicare UPIN